How Do You Know When Trauma is Healed?

I’ve been working with a client who recently realized, and then confided in me, that they were carrying trauma from childhood abuse and it was making their life unmanageable.  What struck me was that they hadn’t known this before - they’d been living this way for so long that it just seemed normal to them.  The experience of constant anxiety, hyper-vigilance for perceived threats, and extreme willingness to blame themselves for anything that went wrong was just the air they’d been breathing for the past 30 years.  They hadn’t been having flashbacks to the trauma, they had been living it every moment of their life.

Trauma is a word that seems to have been a victim of its own PR - while it’s great that people are much more widely aware of trauma as a psychological concept, its broad usage has led to a softening of its definition in the broader consciousness.  When I talk with clients about trauma, what I’m talking about is an event that had such a profound effect on a person that it bends the entire arc of their life around it, changing their thoughts and behaviors for every moment after.  Trauma is not just a bad thing that happened to you…but it can become one.

Trauma is healed when it stops being an event that is continuously occurring in the victim’s mind, to simply a very bad thing that happened to them a long time ago.  And the way that this is done is through changing the internal relationship that a person has to that experience, moving it from a kind of open psychic wound to simply a bad memory.

To create this movement from wound to memory, we need to understand what happens when a person survives a traumatic event.  The human body has a number of operations that it engages without needing to engage in conscious thought - things like breathing, digesting, some would even say thinking.  One of these operations is also trauma response.  During trauma response, the conscious mind recedes from its usual perch in the ‘front seat’ and the unconscious takes over, typically running a fight, flight, freeze, or dissociate reaction to the events that are causing this operation.

The benefit of this is that the unconscious, unburdened by having to send thought through the quality control system of the prefrontal cortex, operates much faster than the conscious - a huge boon in survival situations.  The cost is that the conscious mind is forced into an observer role, and feels powerless and confused during a life threatening situation, which often leads long-lasting emotional scars.

Because the trauma response occurs while the conscious mind is receded, it sometimes doesn’t process completely.  By process, I mean the mechanism by which events move from active experience to memory.  The conscious mind is out of control during the trauma, so it doesn’t get to participate in the resolution on the event.  As such, it is left stuck in a state of hyper vigilance - always looking for the continuation and conclusion of the experience around every corner, in every interaction.

In order to work with this in the here and now, I take clients through a two phase process.  The first, arguably most important, phase is using sensationally guided imagination to create a summonable experience of safety - often something they haven’t felt in a long time.  For some, just feeling that and becoming accustomed to it is enough to melt through the years of frozen terror.

For my clients who need more than to simply be reminded that a feeling of safety is available to them, the second phase involves looking inside, finding that part of them  who is still struggling against the traumatic event, and coaxing it, like a stray animal to a bowl of food inside a warm home, to the safety that awaits it in the present moment.

This is often very difficult for the client, because I’m asking the part of them that is controlling every element of their life in order to create a false sense of control over the trauma to interact with the pate of them that feels completely out of control.  It’s a meeting between the defense and what is being defended against, but over time, all things can be conjoined.  And in this conjunction, both parts are changed - the out of control part comes to see that not everything is a trap, and the too in control part comes to see that not everything needs to be managed.  The self changes, and in doing so, its relation to itself changes.